PROJECT SUMMARY The brain is the most frequent site of crippling and incurable human disease. Neurosurgeons are ideally positioned to advance and translate neuroscience discoveries, but it is a stark minority that are able to build a career as a physician-scientist successfully. Training programs, including our own, have been deficient in their provision of three essential components to delivering neurosurgeon-scientists to the field: 1) Opportunity; 2) Mentorship; 3) Continuity. We have examined the difficult truth of poor productivity from our prior R25 awardees, dissected our failures, and designed new and innovative programmatic approaches, specifically molded to 1) expand opportunities; 2) re-address mentorship; and 3) redefine entirely the look of sustained departmental commitment to developing and maintaining neurosurgeon-scientists. Herein, we offer a fresh enthusiasm, focus, and approach for addressing the problem of how to deliver and sustain neurosurgical research contributions. The program proposed here provides a unique and organized approach to engage, support, and maintain neurosurgery trainees in mentored research. Our hypothesis is that implementation of a formal physician- scientist training track, coupled with a committee-based mentored research experience and an unprecedented commitment to longitudinal support for trainees who secure funding will result in improved realization of independently-funded academic careers for neurosurgeon-scientists. Toward that end, our Specific Aims are to optimize/provide: 1. Opportunity. Our neurosurgery residency has been re-designed to include a Physician-Scientist Track that proffers a weekly Academic Day during junior residency, a PhD-thesis style Research Mentorship Committee, a core curriculum, a vetted and reviewed R25 application, mentored/supported research PGY years 4-6, and a 7th ?transition to practice? year that teaches trainees to divide time successfully between clinical and research responsibilities. 2. Mentorship. Physician-Scientist Track residents will identify a primary research mentor from among 29 approved Duke faculty mentors grouped into 9 distinct Research Concentrations. A PhD-style Research Mentorship Committee will be formed to mentor the resident throughout training. 3. Continuity. R25 recipients will receive matched funds from Neurosurgery to support their research endeavors during the clinical years separating their R25 award in PGY4 from the PGY7 ?transition to practice? year.